Real-World Study on Length of Hospital Stay and Economic Burden of AECOPD Inpatients in a Traditional Chinese Medicine Hospital in China
Author(s)
Huimin Zou, PhD1, Jianyong Qiu, PhD2, Wei Ouyang, PhD2, Yanlian Feng, MSc1, Honghao Shi, PhD3, SHENGQI CHEN, PhD4, Lijun Ma, PhD1, Yunfeng Lai, PhD1.
1School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China, 2Guangdong Second Provincial Traditional Chinese Medicine Hospital, Guangzhou, China, 3International Research Center for Medicinal Administration, Peking University, Beijing, China, 4AstraZeneca Pharmaceutical Technology(Beijing)Co.,Ltd., Beijing, China.
1School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China, 2Guangdong Second Provincial Traditional Chinese Medicine Hospital, Guangzhou, China, 3International Research Center for Medicinal Administration, Peking University, Beijing, China, 4AstraZeneca Pharmaceutical Technology(Beijing)Co.,Ltd., Beijing, China.
OBJECTIVES: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) causes high hospitalization rates and resource use in the elderly. This study evaluates factors influencing length of stay (LOS), resource‐utilization patterns and cost structure in a Traditional Chinese Medicine (TCM) hospital to inform integrated treatment pathways and insurance decisions.
METHODS: We retrospectively analyzed 1,015 first‐admission AECOPD inpatients at the Guangdong Second Provincial Traditional Chinese Medicine Hospital from 2018 to 2023, integrating electronic medical records and cost data. Multiple linear regression examined LOS as the dependent variable, with age, sex, test frequency, Western medicine use, Chinese medicine use and granule prescriptions as independent variables. Descriptive statistics summarized test and prescription frequencies and cost composition (n = 1,027 for cost analysis).
RESULTS: Mean age was 75.9 ± 7.2 years; 84.5% were male. Median LOS was 11.7 days (IQR 7.0-14.0). Age (β = 0.165, p < 0.001) and test frequency (β = 0.087, p < 0.001) were positively associated with LOS, while Western medicine use shortened LOS (β = -2.72, p = 0.013). Chinese medicine use showed a non‐significant LOS increase (β = 2.20, p = 0.102). A total of 3,647 laboratory tests were performed; there were 24,197 Western medicine prescriptions (mean 23.8 per case) and 21,969 Chinese medicine granule prescriptions (mean 21.6 per case), most commonly Glycyrrhiza uralensis and Pinellia ternata. Median total cost was ¥14,239.3 (mean ¥19,713.7); treatment fees accounted for 34.4%, Western drugs 24.2% and tests 15.2%. Reimbursement rate was 77.7%; patient co‐payment 22.3%.
CONCLUSIONS: Older age and greater test frequency significantly prolong LOS in AECOPD inpatients at a TCM hospital. Western medicine reduces LOS, while Chinese granules—despite frequent use—have minimal impact on LOS and cost share. Standardizing testing, optimizing medication use and implementing differentiated payment models may enhance integrated care and insurance reform.
METHODS: We retrospectively analyzed 1,015 first‐admission AECOPD inpatients at the Guangdong Second Provincial Traditional Chinese Medicine Hospital from 2018 to 2023, integrating electronic medical records and cost data. Multiple linear regression examined LOS as the dependent variable, with age, sex, test frequency, Western medicine use, Chinese medicine use and granule prescriptions as independent variables. Descriptive statistics summarized test and prescription frequencies and cost composition (n = 1,027 for cost analysis).
RESULTS: Mean age was 75.9 ± 7.2 years; 84.5% were male. Median LOS was 11.7 days (IQR 7.0-14.0). Age (β = 0.165, p < 0.001) and test frequency (β = 0.087, p < 0.001) were positively associated with LOS, while Western medicine use shortened LOS (β = -2.72, p = 0.013). Chinese medicine use showed a non‐significant LOS increase (β = 2.20, p = 0.102). A total of 3,647 laboratory tests were performed; there were 24,197 Western medicine prescriptions (mean 23.8 per case) and 21,969 Chinese medicine granule prescriptions (mean 21.6 per case), most commonly Glycyrrhiza uralensis and Pinellia ternata. Median total cost was ¥14,239.3 (mean ¥19,713.7); treatment fees accounted for 34.4%, Western drugs 24.2% and tests 15.2%. Reimbursement rate was 77.7%; patient co‐payment 22.3%.
CONCLUSIONS: Older age and greater test frequency significantly prolong LOS in AECOPD inpatients at a TCM hospital. Western medicine reduces LOS, while Chinese granules—despite frequent use—have minimal impact on LOS and cost share. Standardizing testing, optimizing medication use and implementing differentiated payment models may enhance integrated care and insurance reform.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD96
Topic
Economic Evaluation, Health Policy & Regulatory, Health Service Delivery & Process of Care
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)